This MELD calculator computes the Model for End-Stage Liver Disease score — and MELD-Na — from bilirubin, INR, creatinine and sodium, applying the standard allocation rules used in transplant listing.
MELD = 3.78·ln(bilirubin) + 11.2·ln(INR) + 9.57·ln(creatinine) + 6.43
Three labs, weighted by regression against 3-month mortality, replaced waiting-time-based liver allocation in the US in 2002 — sickest first, by arithmetic. The older bedside sibling is our Child-Pugh Calculator, which adds clinical signs the labs can’t see. Part of our Health Calculators collection.
Worked Example (Verified)
- Bilirubin 2.0, INR 1.5, creatinine 1.2 (defaults): 3.78×0.693 + 11.2×0.405 + 9.57×0.182 + 6.43 = 15.34 → MELD 15
- With sodium 130: MELD-Na = 15 + 1.32×7 − 0.033×15×7 = 15 + 9.24 − 3.47 = 20.8 → 21 — hyponatremia’s independent mortality signal, worth six points here
- The floor rules matter: bilirubin 0.8 counts as 1.0 (ln 1 = 0) — no negative contributions; a creatinine of 5 counts as 4
- MELD 3.0 (adopted in US allocation in 2023) adds albumin and sex and re-weights interactions — this page implements the classic MELD/MELD-Na; listing centers compute the current official version
Reading the Scale
- 6 is the floor (least sick listable), 40 the cap; exception points (e.g. HCC) can add beyond labs in allocation policy.
- Small lab wiggles move scores: creatinine’s coefficient (9.57) makes renal function the loudest single voice per log unit.
- MELD was built for prognosis (originally TIPS outcomes), then repurposed for allocation — a formula with a biography.
- Scores recalculate constantly on the list; a static number is a frame from a film.
Related Tools
- Child-Pugh Calculator — the clinical-signs classification
- GFR Calculator — kidney function staging
- Health Calculators — the full collection
Frequently Asked Questions
How is the MELD score calculated?
MELD = 3.78×ln(bilirubin) + 11.2×ln(INR) + 9.57×ln(creatinine) + 6.43, with labs floored at 1.0, creatinine capped at 4.0 (dialysis counts as 4.0), the result rounded and bounded between 6 and 40. Bilirubin 2.0, INR 1.5, creatinine 1.2 gives 15.34 → MELD 15.
What is MELD-Na and how does it differ?
MELD-Na adds serum sodium (for MELD > 11): MELD + 1.32×(137 − Na) − 0.033×MELD×(137 − Na), with Na clamped to 125–137. The defaults with Na 130 yield 21. Hyponatremia independently predicts mortality in cirrhosis, which is why allocation systems incorporated it.
What MELD score is needed for a liver transplant?
Listing typically begins around MELD 15 (below that, transplant risk historically outweighed waitlist risk in the landmark analysis), but allocation is by score order and region — patients are transplanted across a wide range depending on organ availability, exceptions and status (acute liver failure is Status 1A, outside MELD entirely).
What does a MELD of 15 mean for mortality?
In the original validation cohorts, MELD 10–19 corresponded to roughly 6% 3-month mortality; 20–29 ≈ 20%; 30–39 ≈ 53%; 40 ≈ 71%. Modern figures differ with MELD 3.0, better care and different populations — the bands orient, they don’t prophesy.
What is MELD 3.0?
The 2021-updated model adopted for US allocation in July 2023: it adds albumin and female sex, adjusts coefficients, and includes interaction terms, improving accuracy (notably for women, who creatinine disadvantaged). This calculator implements the classic MELD and MELD-Na formulas and says so — official listing uses MELD 3.0.
Is this MELD calculator free?
Yes — free, instant, no sign-up. An educational aid; transplant decisions rest with listing centers using the official current formula.